Integrated care pathway in individuals with Long COVID: STIMULATE-ICP, a cluster-randomized, phase 3 trial

Nature Medicine, Published online: 28 July 2026; doi:10.1038/s41591-026-04552-x

This cluster-randomized phase 3 trial examining the effectiveness of integrated care pathways comparing usual care with the addition of MRI imaging (Coverscan), or a digitally enabled rehabilitation platform app, or both (Coverscan + app), or neither, found specialist Long COVID care improved fatigue response in all arms.

Comprehensive Human Vagus Nerve Map Unveiled

Scientists at Northwell Health’s Feinstein Institutes for Medical Research said they have released the world’s first comprehensive human vagus nerve anatomical map. The achievement could change our understanding of the autonomic nervous system and accelerate the development of bioelectronic medicine and neuromodulation therapies, according to the researchers.

The first dataset release, collected over three years from 30 human donors encompassing 60 vagus nerves, is now available to the global scientific community via SPARC Science.

The vagus nerve is the longest cranial nerve and a critical “information superhighway,” consisting of two main bundles (one on the left side of the neck and the other on the right side of the neck) containing more than 200,000 individual nerve fibers stretching from the brainstem to all major organs.

Stavros Zanos, MD, PhD [Feinstein Institutes]
Stavros Zanos, MD, PhD [Feinstein Institutes]

The nerve manages automatic functions such as heart rate, breathing and digestion, and serves as the body’s “on/off switch” for immune response and inflammation. To better understand the function of each vagal fiber, this new dataset resource offers a 3D view into the intricate anatomy of the human vagus nerve, utilizing techniques such as microCT imaging, immunohistochemistry, and ultrasound.

By mapping the organization of fascicles and fibers, investigators expect to gain critical insights into how the vagus nerve communicates with various organs and influences human health and disease.

“This dataset represents a major step forward in bioelectronic medicine, offering the most detailed anatomical reconstruction of the human vagus nerve to date,” said Stavros Zanos, MD, PhD, associate professor in the Institute of Bioelectronic Medicine at the Feinstein Institutes and co-leader of the project. “For the first time, we can visualize the vagus nerve’s complex architecture that will allow us to design more precise, effective and safe neuromodulation therapies and devices.”

The accomplishment marks a milestone that began with a $6.7 million National Institutes of Health (NIH) grant awarded to the Feinstein Institutes in October 2022 for its Reconstructing Vagal Anatomy (REVA) project, part of the NIH Common Fund’s SPARC program. The successful delivery of the map was supported by Peter J. Pappas, Jr., whose donation provided philanthropic support towards the goals of this project.

Kevin J. Tracey, MD [[Feinstein Institutes]
Kevin J. Tracey, MD [Feinstein Institutes]

“Decoding the vagus nerve’s intricate language is an important advance for science and medicine,” said Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes, Karches Family Distinguished Chair in Medical Research and author of the book The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes“This knowledge will further empower researchers to re-engineer human biology and unlock novel therapies for future patients.”

The Feinstein Institutes for Medical Research is a global scientific leader in bioelectronic medicine and vagus nerve stimulation, where medical researchers use modern technology to develop new device-based therapies to treat disease and injury, according to a Feinstein spokesperson, who points out that the field of bioelectronic medicine integrates insights from neuroscience, molecular medicine and biomedical engineering, and researchers at the Feinstein Institutes leverage the connection between the brain and the immune system to develop bioelectronic medicine interventions.

The vagus nerve helps regulate blood pressure, heart rate, sleep, mood, breathing, bladder function, digestion, and the immune system. [Feinstein Institutes]
The vagus nerve helps regulate blood pressure, heart rate, sleep, mood, breathing, bladder function, digestion, and the immune system. [Feinstein Institutes]

The discovery that initiated the field of bioelectronic medicine—called the “inflammatory reflex”—was made more than 30 years ago by Tracey, continues the Feinstein official. This discovery emerged from studies on vagus nerve signaling and showed that the brain and body communicate to regulate inflammation and, if uncontrolled, inflammation could lead to disease, said Tracey.

It was the first FDA-approved vagus nerve stimulation device in July 2025 to treat rheumatoid arthritis. Northwell Health was the first in the nation to implant the newly approved treatment in patients in August 2025.

Today, engineers, computer scientists, immunologists, neuroscientists and clinicians develop cutting-edge medicine, including neuroimmune modulation, miniature implants for stimulating and recording the vagus nerve, noninvasive ultrasound neuromodulation to suppress inflammation, and novel brain-computer interfaces to overcome injuries of the nervous system, according to a Feinstein Institutes statement. These collaborative efforts are focused on converging to create personalized, precise treatments that hold promise in treating acute and chronic diseases, often with fewer side effects compared to current therapies.

Scientists believe these treatments have the potential to enhance or replace existing treatments across a range of conditions such as arthritis, heart disease, inflammatory bowel diseases, diabetes, cancer, and autoimmune disorders. By producing bioelectronic medicine knowledge, disease and injury could one day be treated by our own nerves without costly and potentially harmful pharmaceuticals, predict a number of researchers.

 

 

 

The post Comprehensive Human Vagus Nerve Map Unveiled appeared first on GEN – Genetic Engineering and Biotechnology News.

Implementing a Smartphone and Wearable-Based Stress Management Intervention in Women With Coronary Artery Spasms to Reduce Cardiac Symptoms: Multicenter, Single-Arm, 1-Way Crossover Study

Background: Mental stress is a well-known trigger of cardiac symptoms in patients with coronary artery spasms. Hence, stress management is recommended along with medical therapy. However, specific programs for patients with coronary spasms are lacking. We collaborated with patients to develop a smartphone-based app as a tailored solution. The app provides biofeedback based on heart rate variability–driven stress level estimations. Objective: This study aimed to evaluate the effect of a biofeedback-driven smartphone stress management app on cardiac symptoms in women with coronary vasospasms. Methods: We enrolled 117 women aged 18 to 70 years diagnosed with coronary vasospasms, as confirmed by a gold standard coronary function test. A multicenter, single-sequence, 2-period crossover study was conducted, comprising a 4-week control period followed by a 4-week period using the Wavy intervention app. The intervention comprised breathing-based exercises that were prompted when measured stress levels were too high. The primary outcome was the Seattle Angina Questionnaire Summary Score, and the secondary outcomes included the 36-Item Short Form Health Survey and the Perceived Stress Scale-10 items. Additionally, the user experience and the impact of the breathing exercise on heart rate variability were evaluated. Results: A total of 102 patients completed the study, yet no significant improvements were observed in the Seattle Angina Questionnaire following the intervention period, with the control group scores at 50.4 (SD 15.4) and the intervention group scores at 50.9 (SD 15.0; <i>P</i>=.92). Similarly, no differences were found in the 36-Item Short Form Health Survey and the Perceived Stress Score. However, the 1236 breathing relaxation exercises performed during the study led to a significant improvement in heart rate variability, as indicated by a median root mean square of successive differences increase from 18.59 (IQR 8.38-36.58) milliseconds before the exercises to 34.93 (IQR 24.19-50.64) milliseconds after the exercises (<i>z</i>=−13.72; <i>P</i><.001). Furthermore, two-thirds of participants (68/102, 66.7%) indicated that they would use a more refined version of the app in the future. Conclusions: A 4-week intervention using the Wavy app did not significantly alleviate anginal symptoms in female patients with coronary vasospasms. However, the breathing exercises demonstrated a notable improvement in heart rate variability, suggesting a reduction in stress levels. Patient feedback indicated broad support for the app and its wearable-based functionality, emphasizing the need for substantial refinements. Future development should incorporate patient perspectives to optimize the app as a comprehensive lifestyle management tool. Clinical Trial: ClinicalTrials.gov NCT06171893; https://classic.clinicaltrials.gov/ct2/show/NCT06171893

Governing AI for Mental Health: Fragmented State Approaches and the Case for a Federal Framework

State-level regulation of AI used for mental health is emerging in the absence of a federal framework. States are taking different approaches to regulation, resulting in a fragmented regulatory landscape. This Viewpoint aims to identify the governance approaches that US states are using to regulate the use of AI in mental health and analyze the limitations of each. A 4-state case analysis was conducted using the statutory text of bills and laws in Illinois, Utah, New York, and Nevada. Two governance approaches were identified. The first regulates the use of AI in clinical contexts, and the second regulates the technology itself. Some states have combined elements of both approaches to address AI use more comprehensively. While these approaches aim to mitigate harm, they differ in where they believe risk lies in the use of AI for mental health support. The limitations of these divergent approaches include uneven protections for consumers and regulatory uncertainty for developers, vendors, deployers, and clinicians. Because AI in mental health operates across both clinical and consumer domains, neither approach alone can address the risks associated with its use for mental health support. A coordinated, risk-based federal regulatory floor is needed to ensure consistent protections across states.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/264dd5ed91097e9ccfcb6d0890920304" />

STAT+: Preliminary trial results suggest a path to a safer Alzheimer’s treatment

An interim look at an Alzheimer’s disease clinical trial evaluating an amyloid-targeting treatment from ProMIS Neurosciences showed low rates of brain bleeding and no incidences of brain swelling — results reported Tuesday that suggest the drug could be safer than approved treatments. 

In a blinded analysis that pooled safety data from patients receiving the ProMIS drug and a placebo, the total rate of ARIA was 4.4%, with all cases mild and asymptomatic, the company said. 

None of the patients experienced ARIA-E, which is the more severe side effect that causes brain swelling. All the cases were characterized as ARIA-H, which involves tiny bleeds in the brain. 

Continue to STAT+ to read the full story…

Samsung’s chip workers are jumping ship to rival SK Hynix 

Lee, an engineer at Samsung’s semiconductor division, clocks out when his shift ends. He used to work longer hours, going the extra mile to excel at his projects. But lately, he’s been coming straight home to work on his job application for the chipmaker’s South Korean rival SK Hynix, sharing tips with his coworkers on how to draft a stellar personal statement. Even his boss encourages him to make the move.

“My team lead tells us all to jump ship to SK Hynix,” says Lee. He and his coworkers are feeling demoralized by the $476,000 bonus that SK Hynix is set to pay its employees, flush with record profits from making the high-bandwidth memory (HBM) chips that power Nvidia’s AI accelerators. The figure dwarfs what chip workers at Samsung are set to receive and is sparking an exodus.

As the AI boom heats up, the semiconductor titans are waging a fierce talent war with flashy bonuses, aggressive recruiting, and even a courtroom injunction. Who wins could tilt the race to dominate the next generation of the HBM chips at the heart of the AI boom.

“Except for our two team leads, my entire team [of 30 people] just applied to SK Hynix,” Lee says, referring to a job posting the company published in July. Lee, who has worked at Samsung for three years, even applied for an entry-level position at its rival. A coworker, who has worked at Samsung for eight years, applied for the same one. They both got rejected. But they’re hopeful that they’ll get a callback for a posting seeking a more experienced engineer.

All employees at Samsung and SK Hynix that MIT Technology Review spoke with asked to be identified by just their last name or a pseudonym because they feared retaliation from their employer. Samsung declined to comment, and SK Hynix did not respond to requests for comment.

After prolonged negotiations with its labor union, Samsung struck a deal in May to pay out 10.5% of the semiconductor division’s operating profits to employees as bonuses annually for 10 years, mostly in company stock that vests over three years. The move came after SK Hynix agreed last year to pay out 10% of operating profits to employees, which translates to $476,000 per employee this year—mostly in cash.  

But at Samsung, each division’s bonus is tied to its own bottom line. Chip workers in its memory division, which is also reaping a windfall from making HBM chips, are getting paid a bonus of roughly $400,000 per employee this year. But those who, like Lee, work in Samsung’s foundry division, which manufactures logic chips that companies like Tesla and Google design and has been operating at a loss, are getting a bonus of roughly $135,000

Employees told MIT Technology Review that Samsung said it can’t give as many bonuses to divisions that aren’t performing well. Lee, after watching the labor union wrestle with the company for months, says he has felt disappointed by what he ended up with: “Even if Samsung does well in the future, I don’t think any of it will trickle down to me.” 

The workers’ lagging bonuses are making SK Hynix suddenly look appealing. According to a survey by the Samsung labor union in June, 81.5% of employees in the company’s foundry division, and nearly half of employees in the semiconductor division as a whole, said they wanted to go to another company in the next two years. In April, Samsung labor union chief Choi Seung-ho said more than 200 members of the union had left for SK Hynix over the past four months. On Blind, an anonymous workplace forum, a chorus of disgruntled engineers at Samsung confess that they want to defect to SK Hynix for the bigger bonuses. 

For decades, SK Hynix lived in Samsung’s shadow. It was the smaller, scrappier memory maker that elite engineering students at universities looked past when applying for jobs. But in 2019, Samsung downsized its HBM team, betting the market would stay niche, while SK Hynix doubled down on the technology. Then the AI boom supercharged the demand for HBMs, which feed AI chips the enormous amounts of data they need at ultra-high speed, driving prices to unprecedented levels. SK Hynix now leads the global market for HBMs, while Samsung is playing catch-up. Both companies topped $1 trillion in market value in May, and SK Hynix briefly dethroned Samsung as South Korea’s most valuable company in June.

Predicting that demand for memory chips will continue to surge, the semiconductor titans are making aggressive investments to expand their business. Last month, the companies unveiled plans to invest more than $2 trillion by 2040, including a semiconductor “mega-cluster” in Yongin, a city south of Seoul. To staff the expansion, SK Hynix added 2,152 employees in the first half of 2026 alone and aims to double its manufacturing capacity in five years. Samsung plans to hire 60,000 employees over the next five years, especially for its semiconductor division. Even so, the pipeline will fall short: South Korea’s semiconductor industry will need about 304,000 workers by 2031 and faces a shortage of roughly 54,000, according to the Korea Semiconductor Industry Association.

Now the longtime rivals are showering workers with big bonuses to keep—and poach—talent. “[SK Hynix] seems to target Samsung engineers when hiring because it’s a rival,” says Baek, a manager at SK Hynix. “From what I heard internally, the big performance bonuses we got were aimed at luring away talent from our competitor.”

Courts are starting to weigh in. In July, Samsung won an injunction barring two former chip workers from working at SK Hynix for 18 months, on the grounds that chips are a national core technology deserving protection. “With competition in the semiconductor industry fierce, it’s necessary to establish a fair market order,” the court ruled.

The talent exodus threatens a crucial advantage that Samsung still holds in the HBM race. “Samsung is the only memory maker in the world that owns a foundry business,” says Park Jun-young, a semiconductor expert at the Industrial Anthropology Laboratory, a research institute, who worked at Samsung for a decade. 

With the latest generation of the technology, known as HBM4, the logic chip at the base of each memory stack must be manufactured with the kind of advanced process that only foundries run. Samsung can do this in-house, while SK Hynix outsources it to the Taiwanese foundry giant TSMC. “If Samsung keeps losing engineers in the foundry … the collaboration between memory division and foundry division could become difficult,” says Park. “SK Hynix, which used to have only a memory team and is now hiring foundry engineers, could do better research on HBMs.”

Choi, an engineer who has worked at Samsung for seven years, says he was once a star on his team, getting glowing performance reviews from his managers. But lately, he and his coworkers have been busy applying for every SK Hynix job posting they see. “We tell each other when the next SK Hynix job posting is up,” he says. “There’s always more work to do beyond our basic duties. But there’s no point in doing it.”